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Nkya S, Mtei L, Soka D, Mdai V, Mwakale PB, Mrosso P, Mchoropa I, Rwezaula S, Azayo M, Ulenga N, Ngido M, Cox SE, D'Mello BS, Masanja H, Kabadi GS, Mbuya F, Mmbando B, Daniel Y, Streetly A, Killewo J, Tluway F, Lyimo M, Makani J. Newborn screening for sickle cell disease: an innovative pilot program to improve child survival in Dar es Salaam, Tanzania. Int Health 2020; 11:589-595. [PMID: 31145786 DOI: 10.1093/inthealth/ihz028] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 02/01/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a recognized cause of childhood mortality. Tanzania has the fifth highest incidence of SCD (with an estimated 11 000 SCD annual births) worldwide. Although newborn screening (NBS) for SCD and comprehensive healthcare have been shown to reduce under-5 mortality by up to 94% in high-income countries such as the USA, no country in Africa has maintained NBS for SCD as a national health program. The aims of this program were to establish and evaluate NBS-SCD as a health intervention in Tanzania and to determine the birth prevalence of SCD. METHODS Muhimbili University of Health and Allied Sciences conducted NBS for SCD from January 2015 to November 2016. Dried blood spot samples were collected and tested for SCD using isoelectric focusing. RESULTS Screening was conducted on 3981 newborns. Thirty-one (0.8%) babies had SCD, 505 (12.6%) had sickle cell trait and 26 (0.7%) had other hemoglobinopathies. Twenty-eight (90.3%) of the 31 newborns with SCD were enrolled for comprehensive healthcare. CONCLUSIONS This is the first report on NBS as a health program for SCD in Tanzania. The SCD birth prevalence of 8 per 1000 births is of public health significance. It is therefore important to conduct NBS for SCD with enrollment into a comprehensive care program.
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Affiliation(s)
- Siana Nkya
- Dar es Salaam University College of Education, Dar es Salaam, Tanzania.,Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lillian Mtei
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Deogratias Soka
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Vera Mdai
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Promise B Mwakale
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paul Mrosso
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Issa Mchoropa
- Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Delloite and Touche, Dar es Salaam, Tanzania
| | - Stella Rwezaula
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Mary Azayo
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Nzovu Ulenga
- Management and Development for Health, Dar es Salaam, Tanzania
| | - Melkiory Ngido
- Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Delloite and Touche, Dar es Salaam, Tanzania
| | - Sharon E Cox
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Graduate School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan.,Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Brenda S D'Mello
- Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), Dar es Salaam, Tanzania
| | | | - Gregory S Kabadi
- Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
| | - Frederick Mbuya
- Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno Mmbando
- Dar es Salaam University College of Education, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - Yvonne Daniel
- Public Health England, NHS Sickle Cell and Thalassemia Screening Programme and National Healthcare Public Health Division, London, UK
| | - Allison Streetly
- Public Health England, NHS Sickle Cell and Thalassemia Screening Programme and National Healthcare Public Health Division, London, UK
| | - Japhet Killewo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Furahini Tluway
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Magdalena Lyimo
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,National Blood Transfusion service, Dar es Salaam, Tanzania
| | - Julie Makani
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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